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Export Provider Record NPI 1134947328
Coffee Road Surgery Center, Llc
Organization Subpart: NO
Active
NPI Number1134947328
NPI TypeNPI-2 Organization
SpecialtyClinic/Center, Ambulatory Surgical
Provider Details
NPI1134947328
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2024-09-27
Last Updated2026-05-08
Authorized OfficialEric Boon
Officer/AO
Phone: 4805670269
Mailing Address1335 Coffee Rd Ste 201
Modesto, CA 95355-3192
United States
Phone: (209) 492-0483
📍 View Map
Primary Practice Address1335 Coffee Rd Ste 201
Modesto, CA 95355-3192
United States
Phone: (209) 492-0483
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes261QA1903X – Clinic/Center, Ambulatory Surgical--
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About NPI 1134947328

Coffee Road Surgery Center, Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1134947328. The primary specialty listed is Clinic/Center, Ambulatory Surgical. The organization is located in Modesto, CA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2024-09-27. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1134947328?

NPI 1134947328 belongs to Coffee Road Surgery Center, Llc, a Clinic/Center, Ambulatory Surgical in Modesto, CA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1134947328 active?

The current status of NPI 1134947328 in the NPPES registry is Active. The record was last updated on 2026-05-08.

What specialty is NPI 1134947328?

NPI 1134947328 is classified under the taxonomy Clinic/Center, Ambulatory Surgical. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1134947328?

You can verify NPI 1134947328 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1134947328?

The primary practice address on file for NPI 1134947328 is 1335 Coffee Rd Ste 201, Modesto, CA 95355-3192. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1134947328 issued?

NPI 1134947328 was first issued (enumerated) on 2024-09-27. The NPPES record was last updated on 2026-05-08.

Practice Location Map

Coffee Road Surgery Center, Llc is located at 1335 Coffee Rd Ste 201, Modesto, CA. Use the map below to find directions or verify the practice location.

📍 1335 Coffee Rd Ste 201, Modesto, CA 95355-3192  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Coffee Road Surgery Center, Llc. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-08-17 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162